LASIK, or Laser-Assisted In Situ Keratomileusis, reshapes the cornea to correct common vision issues like nearsightedness, farsightedness, and astigmatism. This elective surgery offers a path to reduced reliance on glasses and contact lenses. While many factors determine a patient’s suitability, age is one of the most significant initial filters used by regulatory bodies and surgeons. Understanding these age-related guidelines is the first step in determining if you are a candidate.
Minimum Age Requirements for LASIK
The standard minimum age to undergo LASIK in the United States is 18, a requirement established by the U.S. Food and Drug Administration (FDA). This threshold is based on the expectation that eye development and prescription changes have largely stabilized by the time a person reaches legal adulthood. Many refractive surgeons, however, prefer to wait until a patient is in their early to mid-twenties.
Vision can continue to change throughout the early twenties, particularly with myopia (nearsightedness), even though the FDA approves the procedure for those 18 and older. In rare medical circumstances, such as a child with a significant difference in prescription between their two eyes, a surgeon may seek an exception. Nonetheless, the vast majority of candidates must meet the 18 minimum and satisfy a more important requirement: refractive stability.
The Role of Refractive Stability
Refractive stability requires that a patient’s glasses or contact lens prescription has not changed significantly for a sustained period, typically 12 consecutive months. This stability is considered more important than the patient’s age.
The human eye, particularly the axial length and cornea, continues to grow into late adolescence and early adulthood, causing the refractive error to progress. If LASIK is performed before this growth halts, the reshaped cornea will be treating an error that is still changing. Stability usually means the refractive power has not shifted by more than 0.5 diopters in one year.
Operating on an unstable eye increases the risk of regression, where the original vision problem returns because the eye continued to change after the procedure. For example, a 20-year-old whose prescription is still progressing may be denied surgery, while an 18-year-old with a confirmed stable prescription could be eligible. The surgeon must confirm stability through a review of the patient’s historical eye exam records, often spanning two years.
Age-Related Factors for Older Candidates
There is no maximum age limit for LASIK surgery; eligibility is determined by overall eye health. Suitability becomes more complex after age 40 due to age-related changes in the eye’s natural lens.
Around this time, most people experience presbyopia, a condition where the lens loses flexibility, making it difficult to focus on close objects. Traditional LASIK corrects distance vision but does not prevent or correct presbyopia, meaning older patients may still require reading glasses.
Candidates over 40 may be offered monovision LASIK, a technique where one eye is corrected for distance vision and the other is intentionally left slightly nearsighted to aid with close-up tasks. The increased risk of cataracts, the clouding of the eye’s natural lens, is another factor for older patients. Since LASIK only reshapes the cornea, it cannot address a developing cataract, which may make an alternative procedure like Refractive Lens Exchange a more appropriate solution.
What Happens If You Are Too Young?
If a candidate is younger than the minimum age or has a prescription that is still changing, the procedure is almost always postponed. The eye care professional will typically recommend returning for follow-up examinations to monitor the refractive error.
The risk of prematurely undergoing LASIK is the need for an enhancement, or a second laser procedure, later on. If the eye continues to grow and the prescription regresses, the patient will experience a return of blurry vision, requiring glasses, contacts, or another surgery. Enhancement procedures are not always possible, as they require sufficient remaining corneal tissue to be performed safely. Waiting until refractive stability is confirmed ensures the best chance for a single, lasting vision correction result.